Presenting author biography:

Gen Sander is human rights analyst at Harm Reduction International, where she leads on the organisation's prison and human rights work.

The Global State of Harm Reduction in Prisons: Findings from 2016

Gen Sander

Background: Since 2008, the Global State of Harm Reduction has been tracking the harm reduction response to drug-related harms around the world. While considerable progress has been documented in the broader community, the provision of harm reduction in prison settings has regrettably not advanced in the same way. Since 2014, however, several developments – both positive and negative – have taken place.

Methodology: Information on harm reduction in prisons presented in the Global State was sourced using international scientific and grey literature, reports from multilateral agencies, international governmental and non-governmental organisations, and organisations of people who use drugs. A survey was also sent out to civil society and harm reduction networks to obtain national and regional information on key developments.

Results: Of the 158 countries that report injecting drugs use, only 8 countries currently provide NSPs, while 53 operate OST, in at least one prison. Iran has ceased to provide NSPs in prisons since 2014, signifying the end of prison-based NSP provision in the MENA region. New policy/legal developments in France and Nepal, however, could see NSPs introduced in the countries’ prisons soon. Availability of OST has slightly improved since 2014, with provision in at least one prison documented in 10 new countries. Provision of condoms, naloxone, and diagnostics and treatment for HIV, HCV and TB remain unacceptably restricted.

Conclusion: Progress on harm reduction in prisons has been far too slow, particularly considering that HIV and HCV disproportionately affect prisoners and the special duty of care that states’ have towards this population. Funding and lack of political support continue to major obstacles to prison-based service provision, while accessibility to services continues to be obstructed by, for example, restrictive criteria, long waiting times, and/or fear of stigma and discrimination.